There is a service in Ireland that will send a care worker to your door to help you get out of bed, wash, dress and take your medication. It costs nothing, it is not means tested, and you do not need a medical card. Most people only find out it exists during a hospital discharge meeting, when nobody has the headspace to take it in.
That service is the HSE Home Support Service, and 2026 is the year it began to change. On 1 July the President signed the Health (Amendment) (Home Support Providers) Act 2026 into law, putting home care providers on a public register and under inspection for the first time in the history of the State.
TL;DR
- The HSE Home Support Service is free and not means tested: no income test, no medical card needed, unlike Fair Deal for nursing home care.
- Apply at 65 or over, or younger with early onset dementia or a disability, on a form returned to your local Home Support Office. A family member, GP or public health nurse can help.
- Unhappy with the hours you are given? You have 20 days to ask in writing for a review. Very few people do.
- At the end of June 2026, 5,539 people were waiting: 2,143 for a service, 3,396 for extra hours.
- The 2026 Act brings HIQA registration and inspection, but is not yet commenced, and excludes providers caring for fewer than four people.
What it covers
Home support is help with the ordinary business of the day: in the language of the new Act, the activities of daily living (washing, dressing, eating, toileting, transferring and walking) and the instrumental ones (preparing meals, housework, using a telephone and managing medications).
Two honest limits. It does not replace informal care, so your hours assume whatever your family already does continues. And it cannot provide 24 hour care at home, because the funding is finite.
Free, but not a right
Here is the asymmetry at the heart of Irish care policy. Nursing home care has a statutory scheme behind it: qualify for the Fair Deal scheme and you get it, though it is means tested and you contribute. Home support is the reverse. It costs nothing, and you have no legal entitlement to it at all. It is provided at the discretion of the HSE, within the budget of the year.
Budget 2026 makes the point. Home support received €82 million extra, providing 1.7 million additional hours for a national total of 26.7 million. Fair Deal received €92 million. One has a legal obligation attached, the other does not, which is why a statutory home support scheme has been promised since 2018 and still has not arrived.
How to apply
You apply on a form, not by phone. Get the application and information booklet from your local HSE Home Support Office or print it from the HSE website, then return it completed. A family carer, your GP or your public health nurse can fill it in with you, but you sign the declaration and consent section in Part 1 yourself: that signature is the record that this is your decision, not your daughter’s. If you cannot sign, only someone formally nominated under the assisted decision making arrangements can apply for you, one more reason to put those in place early.
If you are in hospital, ask the person handling your discharge plan. A nurse, discharge coordinator or medical social worker can complete the form with you and send it straight to the right office, by far the fastest route in. Our guide to hospital discharge and recovery at home covers the rest.
The assessment, and the 20 days that follow
A public health nurse, physiotherapist or other health professional then carries out a Care Needs Assessment, increasingly using the interRAI Single Assessment Tool the HSE is rolling out nationally. The assessor looks at how you manage everyday tasks, what medical supports you have, what your family and community supports look like, and what you want. The HSE then writes with its decision.
This is the part almost nobody knows: if you are not happy with that decision, you can write to your local Home Support Office within 20 days setting out why, and the HSE must carry out an impartial review and tell you the outcome. Twenty days is short, and the clock starts when the letter arrives.
One more box on the form deserves attention. Consumer Directed Home Support lets you pick your own provider from the HSE approved list and arrange days and times directly, using a weekly funding amount the HSE confirms in writing. If a family carer covers Tuesdays, this is how you move your hours to Thursday. Tick the box when you apply for it.
Two waiting lists, not one
At the end of June 2026, 5,539 people were waiting for home support, roughly 12% more than a year earlier. That figure hides something important: 2,143 were waiting for a service to start, while 3,396 were already receiving support and waiting on additional hours they had been assessed as needing. Being approved is not the same as being served.
Where you live matters: the West and North West held 1,265 of those people, about 23% of the list, with Dublin and the North East next at 1,165. Delivery is largely outsourced too, with HSE figures reported in August 2026 showing more than two thirds of packages provided by private and voluntary companies.
What the new Act changes
The Act (No. 17 of 2026) amends the Health Act 2007 to bring home support providers under the Chief Inspector of Social Services at HIQA. Registration will last three years. The register will be public, free to inspect and online, showing any conditions attached to a registration and any fine or penalty imposed by a court. Inspectors will be able to visit the home where care is delivered, with the consent of the person receiving it, and interview them and their family in private. Trading without registration becomes an offence carrying up to €70,000 or two years’ imprisonment on indictment.
Two caveats. First, the Act is not yet in force: it commences on days appointed by the Minister for Health, and the regulations and final HIQA standards are still to be published. Second, and more important for families, a provider caring for fewer than four people is excluded from the definition altogether, as is an individual providing care without commercial gain. If you hire a carer privately, they may never appear on the register, so keep doing your own checks: references, Garda vetting, insurance and a written agreement.
What to do this month
If you or someone you love is managing at home but only just, do not wait for a crisis to force the conversation. Ring your local Home Support Office for the application pack and ask your public health nurse for an assessment. Keep a plain diary for a fortnight of what is genuinely difficult, because assessments go better grounded in specifics than in the brave summary most of us give a stranger. And apply before you are desperate.
Críonna Health publishes practical guidance on ageing in place and the supports that make it possible. For independent help with forms and entitlements, ring Citizens Information on 0818 07 4000. If isolation is part of the picture, ALONE runs a support line on 0818 222 024, 8am to 8pm, seven days.
📸 Photo by Vitaly Gariev on Unsplash
